Frequency of publication of research papers by students of a Faculty of Medicine in Lima-Peru

Antecedentes: aproximadamente el 30% de investigaciones realizadas por estudiantes de Medicina son publicadas, variando estos valores entre países. Objetivos: determinar la frecuencia de publicación de las tesis de estudiantes de Medicina en una revista científica hasta tres años posteriores a la sustentación, así como explorar los factores relacionados a dicha publicación. Materiales y Métodos: estudio observacional analítico tipo cohorte retrospectiva. Las unidades de análisis fueron las tesis sustentadas por estudiantes de la Facultad de Medicina de la UPCH durante el periodo enero 2015- mayo del 2018 (n=207). La búsqueda de tesis se realizó en PubMed, SciELO, LILACS y LIPECS. Resultados: la frecuencia de tesis publicadas fue de 28,50%. Existe diferencia en el tiempo que tomó publicar en una revista nacional (10 meses) respecto a una internacional (23,5 meses) (p=0,01). La mayoría de publicaciones encontradas en revistas nacionales (73,47%) tenían más autores estudiantes que no estudiantes; mas no había diferencias en las internacionales. El 27,12% de las tesis publicadas tuvo al menos un estudiante autor que había publicado previamente. Los factores relacionados a la publicación fueron el antecedente de publicación del asesor y tipos de estudio transversal o serie de casos. Conclusiones: la producción científica en la UPCH es similar y en algunos casos mejor a lo reportado en otros países.Background: Almost 30% of investigations done by medical students are published, these values varying between countries. Objectives: To determine the frequency of published theses in biomedical-indexed journals by medical students during the 3 years following their thesis defense oral examination, as well as to explore the related factors with their publication. Methods: Retrospective cohort study. We evaluated theses presented by medical students of Universidad Peruana Cayetano Heredia during January 2015- May 2018 (n = 207). Publication of theses was assessed by searching in PubMed, SciELO, LILACS and LIPECS. Results: The frequency of published theses was 28.50%. There was a difference in the time it took to publish in a national journal (10 months) in comparison to an international one (23.5 months) (p = 0.01). Most of the publications found in national journals (73.47%) had more student authors than non-students; but there was no difference with international journals. Of the published theses, 27.12% had at least one student author who had previously published. Related factors with publication were the consultant’s publication history, and that the study design were cross-sectional or case series. Conclusions: The scientific production among medical students at UPCH is similar and in some cases better than what is reported in other countries

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research